Ke ulu nei ka prevalence o ka diabetes type 2 i ka honua, ʻo ia ke ʻano o ke ʻano o nā kānaka a me nā lako momona. Eia naʻe, ʻaʻole kū ka lāʻau lapaʻau, hoʻomohala i nā mea hou no ka mālama ʻana i ka maʻi maʻi.
ʻO kekahi o nā papa hou o ia mau mea, ʻo ka meleteketin mimetin, kahi e loaʻa ai nā saxagliptin (saxagliptin).
Ka hana o ka hana o ka incretins
ʻO ka incretins kekahi mau kānaka maʻi e ka gastrointestinal tract i ka wā e komo ai ka meaʻai. Ma muli o kā lākou hana, hoʻonui ʻia ka hana o ka insulin, e kōkua ana i ka glucose e hoʻopili, e hoʻopuka i ka wā o ka ʻoni ʻana.
I kēia manawa, ua loaʻa nā mea ʻelua o nā mea hoʻohālikelike.
- GLP-1 (faapeole-like peptide-1);
- ISU (insulinotropic polypeptide).
ʻO nā mea i loaʻa o ka mea mua ma nā ʻōpū ʻē aʻe, e hiki ai iā ia ke hōʻike i kahi ʻoi loa. Kāhea ʻia ka lua e ka pancreatic β-cell receptors.
Ma waena o nā hana pono o kā lākou hana:
- hoʻonui nui o ka huna ʻana o ka insulin hāme e ka pancreatic cell;
- e hoʻolohi ana i ka ʻōpū;
- ka hōʻemi ʻana i ka hana hana glucagon;
- ho'ēmi i ka momona a me ka manaʻo o ka piha piha;
- ka hoʻomaikaʻi ʻana i ka naʻau a me ke kīʻaha koko, he hopena maikaʻi i ka ʻōnaehana o ka pīpī.
Me ka nui o ka hoʻonui ʻana i ka hana o ka insulin, e ʻoi aku ka maikaʻi o ka glucose, akā inā maʻa mau ia, e oki ke kaʻina o ka huna ʻana a ʻaʻole i weliweli ke kanaka i ka hypoglycemia. ʻO ka emi ʻana o ka nui o ka glucoseagon, kahi antagonist insulin, e alakaʻi ana i ka hoʻoemi ʻana i ka ʻai o ka glycogen a me ka hoʻokuʻu ʻana i nā kūmole free, aʻo ka mea like i ka nui o ka hoʻonui ʻana i ka ʻai o glycogen i loko o nā uaua. ʻO ka hopena, hoʻohana koke ka glucose i ka pae hana, me ka ʻole o ka hoʻokomo ʻana i ke kahe koko.
Ke lohi nei ka hoʻokuʻu ʻana o ka ʻōpū, hoʻokomo nā meaʻai i loko o nā wahi i loko o nā wahi liʻiliʻi, e hōʻemi ana i ka nui o nā kōpona o ka glucose i loko o ke koko a, no laila, he māhuahua. Hana ʻia i nā ʻāpana liʻiliʻi, ʻoi aku ka maʻalahi o ia e ke kino. I kēia hihia, kahi hōʻemi o nā mea momona i kau nui ʻia ka ʻai nui.
ʻO nā hopena i ka ʻōnaehana o ka kaila ka mea i ʻike ʻia i kēia manawa ʻaʻole naʻe i ʻike ʻia. Loaʻa ʻia ua loaʻa i ka vitetole e kōkua i ka pancreatic β-cell e wikiwiki hou.
ʻAʻole hiki i ka makou ke loaʻa nā homoni i kā lākou hoʻomaʻemaʻe i ka nui o ka nui, no laila, ua hoʻomohala ʻia e nā ʻepekema nā analogue e hana i nā hana like:
- hoʻopiʻi i ka hopena o ka pehu o ka pehu o ka glucone-1;
- ka hōʻemi ʻana i nā hopena o nā mea hoʻomoe, a laila e hoʻolōʻihi i ke ola o nā hormones.
ʻO Saxagliptin i ka hui lua.
E hoʻokuʻu i nā palapala
ʻO Saxagliptin he ʻāpana o ka lāʻau Onglisa, e hana ana ma ka mea i pale aku i ka DPP-4. ʻAʻole kēia māka ma nā papa inoa federal i nā lāʻau lapaʻau kūikawā, akā hiki ke hāʻawi ʻia i nā mea maʻi me ka maʻi mellitus ma ke kālā kālā kūloko.
Loaʻa ka lāʻau lapaʻau i ke ʻano o nā papa me kahi pūpū melemele, aia kahi 2.5 mg o kaxagliptin a i ʻole 5 mg o kona hydrochloride. Hoʻohui pū ka ʻohu like i nā mea i manaʻo ʻia i ka hopena o ka mea hana. Hoʻokaʻa ʻia nā papa papa e hōʻike ana i kā lākou dosage.
Hoʻopaʻa ʻia nā papa i loko o kahi kāʻei blister o 10 mau ʻāpana a me kahi pahu pahu.
Nā hōʻailona a me nā contraindications
Hoʻomaopopo ʻia nā hoʻomākaukau e hana ʻia ai ʻo Saxagliptin no ka hoʻohana ʻana me:
- ʻO ka hana mua ma mua o ka maʻi maʻi, ka mea e kōkua ai nā hana kuʻuna, a me ke kau ʻana i ka meaʻai, hoʻomaʻamaʻa a me nā ʻōlelo ʻē aʻe kekahi. Hāʻawi ka mea hana iā ʻoe e hooki i ka luku ʻia o nā β-cell a laila hoʻoweliweli i ka hoʻomohala ʻana o ka maʻi type 2;
- ʻO ka heleʻana o kahi maʻi maʻi. I kēia hihia, hiki ke lilo i ka mea hana ma ke ʻano he lāʻau kūʻokoʻa a i hui pū ʻia me nā lāʻau ʻē aʻe:
- Metformin;
- insulin;
- kumuliiu aoli;
- lihuiʻanui.
ʻO nā kumumanaʻo ka lawe ʻana i ka lāʻau lapaʻau nā:
- maʻi mellitus type 1;
- hiki ke hōʻalo kino i kekahi o nā mea o ka lāʻau;
- nā haʻahaʻa kiʻekiʻe i nā DPP-4 inhibitors;
- ka heleʻana o ka ketoacidosis maʻi maʻi;
- ka hemahema o ka lactose a me ka nele o ka lactase, ka malabsorption congenital glucose-galactose;
- manawa o ke gestation a me ka lactation;
- makahiki ʻokoʻa.
I kēia mau hihia, ua hoʻohana ʻia nā analogues o ka lāʻau lapaʻau a i ʻole nā kālā me kahi ʻano like ʻole i koho.
ʻO ka hopena o ka hoʻomaka ʻana i ka therapy saxagliptin + metformin
Nā ʻōkuhi no ka hoʻohana
Lawe ʻia nā papa papaʻa ʻole me ka nānā ʻole i ka hoʻokomo ʻana i ka meaʻai. Komi ʻia ka pahu kālou a holoi ʻia me kahi liʻiliʻi o ka wai. Hoʻokomo ka dosis ma ke ʻano o ka lāʻau lapaʻau a me ka mālama pono o ka mea maʻi.
Me ka hoʻohana kaʻawale, ua ʻōlelo ʻia ka saxagliptin e lawe i ka 5 mg hoʻokahi i ka lā.
I ka hui pū ʻana me nā lāʻau maʻi maʻi maʻi maʻi, ʻo ka nui o ka nui o ka 5 mg i kēlā me kēia lā, pili kēlā me ke hoʻohui ʻana i nā hui like hypoglycemic a me ka saxagliptin.
I ka hoʻomaka mua o ka hoʻohana ʻana o ka waiwai me metformin, ʻoi aku ka nui o ka saxagliptin he 5 milligrams, a ʻo ka metformin he 500 milligrams i kēlā me kēia lā.
No nā mea maʻi me ka pathology keiki, ua hoʻemi ʻia ka nui o ka lāʻau ma 2.5 mg i kēlā me kēia lā. Inā hoʻohana ʻia ka hemodialysis, inu ka lāʻau ma hope o kona kū ʻana. ʻAʻole i ʻike ʻia ka hopena o ka lāʻau i ka wā o ka dialysis peritoneal. I kekahi hihia, ma mua o ke kuhikuhi ʻana i ka lāʻau lapaʻau, aʻo ka poʻe loea e hoʻomaʻamaʻa i nā ʻeha o ka maʻi maʻi.
No nā mea maʻi me nā pathology hana kōpaʻa, ʻaʻohe pono o ka hoʻoponopono ʻana. Hoʻopili ʻia ka mālama ʻia e like me nā ʻōlelo laulā. Hoʻopili kēia i nā maʻi maʻi ʻelemakule, ke hāʻawi nei ʻaʻohe pilikia o ka lāpū.
ʻAʻole i mālama ʻia kahi hōʻike no ka hopena o ka lāʻau lapaʻau ma ka pūpū i nā wahine hāpai a me nā keiki ʻōpio. No laila, he mea paʻakikī ke wānana i kona mau hopena. No kēia mau maʻi maʻi maʻamau, e hoʻohana pinepine ʻia nā ʻoihana ʻē aʻe i hōʻoia ʻia. Inā hele ka wahine i ka saxacgliptin i ka wā o ka umauma, pono ʻo ia e hōʻole ma ka hānai.
I ka hihia o ka hoʻokolohua ʻōwili me nā mea paʻa CYP3A4 / 5 sambekala, ka pāʻina o ka lā o kēlā me kēia lā.
Eia nā lāʻau lapaʻau penei:
- Ketoconazole;
- Clarithromycin;
- Atazanavir;
- Indinavir;
- Aezodon;
- Itraconazole;
- Ritonavir;
- Telithromycin;
- Nelfinavir;
- Saquinavir a me kekahi.
Ke lawe nei i saxagliptin, hoʻomau ka mea hoʻomohala i nā ʻōmua holoʻokoʻa ma ka hoʻonohonoho ʻana o kahi meaʻai, nā hana hoʻoikaika kino a me ka nānā ʻana i ka kūlana psycho-naʻau.
Nā hopena ʻaoʻao a me ka overdose
ʻAʻohe like me ka hopena ʻo ka lāʻau lapaʻau. ʻO kona pōmaikaʻi nui ʻo ia ka nele o ka ʻeha o ka hypoglycemia.
Akā, e like me kekahi lāʻau lapaʻau synthetic, pili ia i nā kaʻina o ka physiological o ke kino, e hāʻawi i ka loli, e hiki ai i ka:
- ka hoʻomohala ʻana o nā maʻi ʻeha o ka ʻōnaehana;
- ʻeha nā huapuni;
- sinusitis
- ke ʻano o kahi o ke poʻo;
- gastroenteritis;
- ka hoʻomohala ʻana o ka mumū i ka ʻoihana genitourinary.
Ke nānā nei i kekahi o kēia mau hōʻailona, pono ʻoe e hoʻopiʻi i ke kauka hele i koho i kahi ala kūpono ʻole o ka lāʻau lapaʻau a hoʻololi paha i nā papa ʻē aʻe.
ʻAʻole i ʻike ʻia ka overdose ma nā hoʻokolohua lapaʻau lāʻau, aʻo ka ʻike ʻana o ka 80 mau manawa i kiʻekiʻe ma mua o ka mea i hōʻike ʻia ʻia. Ma kahi o nā hōʻailona o ka overdose (pōhaʻi, luaʻi, ʻeha, hōʻeha o ka ʻōpū, nāwaliwali, a me nā mea naʻe).
Ke hui pū ʻia me nā lāʻau ʻē aʻe, ʻaʻole i ʻike ʻia nā mea hoʻopunipuni. Eia nō naʻe, ʻaʻole i aʻo ʻia ka hoʻohana pinepine ʻana me metformin a me thiazolidinediones.
Video mai ka loea.
He aha ka mea e hoʻololi ai i ka saxagliptin?
Hoʻohana ʻia ka hoʻohana ʻana i saxagliptin e like me ka mea nui i ka lāʻau Onglise, inā he mea hoʻopiʻi ka mea maʻi, pono ia e hoʻohana i nā analogue, kahi i hoʻohui ʻia nā mea ʻē aʻe o ka enzyme DPP-4:
- Januvia
- ʻO kekahi o nā mea hana mua o kēia ʻano, i hoʻomohala ʻia ma ʻAmelika Huipū ʻia. ʻIke ʻia ia i kahi waihona o 25, 50 a me 100 mg. ʻO ke kaulike o kēlā me kēia lā e pili ana iā 100 mg. Loaʻa ka hopena o ka lāʻau i kahi lā. ʻO kekahi manawa i hana ʻia ma lalo o ka inoa ʻo YanuMet, aia pū kekahi metformin. - ʻO Galvus - kahi lāʻau lapaʻau i hana ʻia ma Suisa, hoʻohana ʻia ma kahi waihona o 50 mg i hoʻokahi lā a i ʻole ka nui, hoʻohana pinepine ʻia me ka insulin.
- Nesina - i hana ʻia ma Irelani, e pili ana i ka apolgiptin benzoate me kahi kaha o 12,5 a i ʻole 25 mg. Lawe ʻia ka papa ʻaina 1 hoʻokahi lā i ka lā.
- Vipidia - ka mea nui o ka alogliptin lāʻau, he hopena like ia, ua lawaiʻa ia i hoʻokahi lā i ka lā ma kahi o 25 mg.
- ʻO Trazhenta - kahi mea e pili ana i ka linagliptin, ua maopopo i ke ʻano o nā papaʻu 5 mg i lawe ʻia ma ke alo.
- ʻO kekahi o nā mea hana mua o kēia ʻano, i hoʻomohala ʻia ma ʻAmelika Huipū ʻia. ʻIke ʻia ia i kahi waihona o 25, 50 a me 100 mg. ʻO ke kaulike o kēlā me kēia lā e pili ana iā 100 mg. Loaʻa ka hopena o ka lāʻau i kahi lā. ʻO kekahi manawa i hana ʻia ma lalo o ka inoa ʻo YanuMet, aia pū kekahi metformin.Hoʻohana ʻia nā mea like'ē aʻe he ʻano ka like, akā, he ʻano like me ka hana. Kūlike ke kumukūʻai o nā lāʻau lapaʻau e like me ke ʻano o ka'āina no ka hana a me ka ʻano o nā lāʻau lapaʻau.
ʻO ke kumukūʻai o ka lāʻau lapaʻau Onglisa, aia hoʻi me saxagliptin, mai 1700 a 1900 mau rubles.
ʻO ka hanauna hou o nā lāʻau lapaʻau e hiki ke hoʻopau wikiwiki a maʻalahi i nā pilikia o ka uptake glucose i loko o nā mea maʻi me ka maʻi mellitus.
ʻOiai ʻaʻole ka laulā loa o kā lākou papa inoa, hoʻokahi hua lāʻau wale nō ma luna o ke kumu saxagliptin, he hopena maikaʻi o ka mālamaʻana i ka maʻi maʻi maʻa ʻaʻole i kahi kūlana o ka hypoglycemia. I ka manawa like, aia nā analogues e loaʻa i kahi ʻano ikaika like ʻole, akā me ka hopena therapeutic like.
